JP2006511448A - 安定化された抗呼吸器合胞体ウイルス(rsv)抗体製剤 - Google Patents
安定化された抗呼吸器合胞体ウイルス(rsv)抗体製剤 Download PDFInfo
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Abstract
Description
本発明は、呼吸器合胞体ウイルス(RSV; respiratory syncytial virus)抗原と免疫特異的に結合する抗体またはそのフラグメントの液体製剤であって、安定性、低いレベルから検出できないレベルの抗体のフラグメント化、低いレベルから検出できないレベルの凝集を示し、かつ、長期保存中でさえ抗体または抗体フラグメントの生物活性(例えば、治療効力)の損失をほとんど示さない製剤から全く示さない製剤に関する。特に、本発明は、RSV抗原と免疫特異的に結合する抗体またはそのフラグメントの液体製剤であって、界面活性剤および/または無機塩を実質的に含んでいない製剤に関する。本発明はまた、RSV抗原と免疫特異的に結合する抗体またはそのフラグメントの液体製剤を使用してRSV感染またはその1以上の症状を予防、治療、管理または改善する方法に関する。
呼吸器合胞体ウイルス(RSV)は乳児および児童の重篤な下気道疾患の主要な原因である(Feigenら編, Textbook of Pediatric Infectious Diseases, WB Saunders, Philadelphiaの1653-1675頁; 新ワクチン開発、優先事項の確立(New Vaccine Development, Establishing Priorities), 第1巻, 1985, National Academy Press, Washington DCの397-409頁; およびRuuskanenら 1993, Curr. Probl. Pediatr. 23: 50-79頁)。RSV感染の1年の流行性は明らかに世界規模であるが、季節ごとのRSV疾患の発生率および重症度は地域によって差がある(Hall, C. B., 1993, Contemp. Pediatr. 10: 92-110頁)。北半球の温暖な地域では、通例、晩秋に始まり、晩春に終わる(Hall, C. B., 1995, Mandell G. L., Bernnett J. E., Dolin R.編, 1995, Principles and Practice of Infections Diseases, 第4版, Churchill Livingstone, New Yorkの1501-1519頁)。米国では毎年、RSV疾患により90,000人が入院し、4,500人が死に至ると推定される。一次RSV感染は6週齢〜2歳の子供で見られることが多く、普通は院内流行期の生活の最初の4週間には起こらない(Hallら, 1979, New Engl. J. Med. 300: 393-396頁)。RSVは、小児細気管支炎全体の75%もの、また、小児肺炎全体の最大40%の原因になっていると推定される(Cunningham, C. K.ら, 1991, Pediatrics 88: 527-532頁)。RSV感染の危険性が高い子供としては、早期産児(Hallら, 1979, New Engl. J. Med. 300: 393-396頁)ならびに気管支肺異形成症(Groothuisら, 1988, Pediatrics 82: 199-203頁)、先天性心疾患(MacDonaldら, New Engl. J. Med. 307: 397-400頁)、先天性または後天性免疫不全症(Ograら, 1988, Pediatr. Infect. Dis. J. 7: 246-249頁; およびPohlら, 1992, J. Infect. Dis. 165: 166-169頁)および嚢胞性繊維症(Abmanら, 1988, J. Pediatr. 113: 826-830頁)の子供が挙げられる。RSV感染で入院する心臓または肺疾患乳児の死亡率は3%〜4%である(Navasら, 1992, J. Pediatr. 121: 348-354頁)。
本発明は、一部、RSV抗原と免疫特異的に結合する抗体またはそのフラグメントの高濃度液体製剤であって、界面活性剤、無機塩および/または他の賦形剤の不在下で、安定性と低いレベルから検出できないレベルの抗体のフラグメント化および/または凝集を示し、かつ、製造、調製、輸送、および保存中に抗体または抗体フラグメントの生物活性の損失をほとんど示さない製剤から全く示さない製剤の開発に基づく。特に、本発明は、RSV抗原と免疫特異的に結合する、極めて強力であり、改善された薬物動態プロフィールを有し、かつ、それゆえに、SYNAGIS(登録商標)と比べて全治療プロフィールが改善されている抗体またはそのフラグメントの液体製剤を提供する。本発明の液体製剤は、RSV感染、その1以上の症状、およびRSV感染に結び付くか、RSV感染により増強されるか、または、RSV感染を増強するその他の呼吸器疾患の予防、治療、管理および/または改善に向けた、RSV抗原と免疫特異的に結合する抗体またはそのフラグメントの投与を容易にする。特に、本発明の液体製剤は、医療従事者が、凍結乾燥製剤の場合に求められるように投与の前に抗体または抗体フラグメントを正確かつ無菌で再構成する必要なく、RSV抗原と免疫特異的に結合する抗体またはそのフラグメントの滅菌投与量を迅速に投与できるようにする。このような液体製剤は長時間の乾燥ステップ、例えば、凍結乾燥、フリーズドライなどを必要としないため、液体製剤は凍結乾燥製剤よりも簡単にかつコスト効率よく製造することができる。この液体製剤は、製剤化される抗体が精製および製剤工程を通して水相にある工程により製造される。好ましくは、液体製剤が乾燥ステップ(例えば、限定されるものではないが、凍結乾燥、フリーズドライ、噴霧乾燥、または風乾ステップ)のない工程により製造される。
上記のRSV抗原と免疫特異的に結合する抗体および/またはそのフラグメントの液体製剤の全てを、本明細書においては、まとめて「本発明の液体製剤」、「本発明の抗体液体製剤」、「RSV抗原と免疫特異的に結合する抗体またはそのフラグメントの液体製剤」、または「抗RSV抗体の液体製剤」と呼ぶ。
(後述の「図面の簡単な説明」の項を参照のこと。)
5. 発明の詳細な説明
本発明の液体製剤は、被験体に製剤を投与する前に、正確かつ無菌で調製物を再構成し、その溶液が清澄化するまで長時間待つという必要がない、その被験体に投与するRSV抗原と免疫特異的に結合する抗体またはそのフラグメントのすぐに使用できる調製物を提供する。これにより、医療従事者による製剤の被験体への投与手順が簡易化される。さらに、保存期間中のその高い安定性から、本発明の製剤は長期にわたる保存期間中のタンパク質の凝集および/またはフラグメント化により抗体またはそのフラグメントの生物活性に不都合な作用を及ぼすことなく、RSV抗原と免疫特異的に結合する抗体またはそのフラグメントを約15mg/ml〜約300mg/mlの範囲の濃度にて含むことができる。このような安定性によって、抗体または抗体フラグメントの効力が保証されるだけでなく、被験体に不都合な作用を及ぼす可能性のあるリスクをも減少する。さらに、製剤に使用する成分が少なければ、汚染を持ち込む危険性も少なくなる。さらに、液体製剤の製造に関する全ての段階が水溶液中で行われ、凍結乾燥およびフリーズドライなどの乾燥工程の必要がないため、本発明の液体製剤の製造工程が簡易化され、凍結乾燥品の製造工程よりも効率的なのである。よって、費用効率もまた高いものとなる。
本発明の液体製剤は、界面活性剤、無機塩、および/または他の賦形剤を実質的に含んでいないが、長期保存中に高い安定性を示す抗体製剤を提供する。特定の実施形態では、このような抗体製剤が均質である。本発明の製剤はヒスチジンを1〜100mMの濃度にて含み、かつ、RSV抗原と免疫特異的に結合する抗体またはそのフラグメントを約15mg/ml〜約300mg/mlの濃度にて含む。1つの実施形態では、本発明の製剤が水または好適な溶媒以外の成分を含まない。特定の実施形態では、本発明の液体製剤に含められるRSV抗原と免疫特異的に結合する抗体または抗体フラグメントがSYNAGIS(登録商標)またはそのフラグメントではない。別の実施形態では、本発明の液体製剤に含められるRSV抗原と免疫特異的に結合する2種以上の抗体または抗体フラグメントを構成する、本発明の液体製剤に含められる抗体または抗体フラグメントの少なくとも1種がSYNAGIS(登録商標)またはそのフラグメントである。
本発明は、RSV抗原と免疫特異的に結合する抗体を含んでなる液体製剤に関する。好ましい実施形態では、本発明は、表1(上記)に記載されている1種以上の抗体を含む液体製剤を提供する。
本発明は、RSV抗原と免疫特異的に結合し、かつ、他の公知の抗RSV抗体、例えば、SYNAGIS(登録商標)と比べて半減期が改善された1種以上の抗体またはそのフラグメントを含んでなる安定な液体製剤を包含する。特に、本発明は、動物、好ましくは、哺乳類、最も好ましくは、ヒトにおいて、3日より長い、7日より長い、10日より長い、好ましくは、15日より長い、25日より長い、30日より長い、35日より長い、40日より長い、45日より長い、2ヶ月より長い、3ヶ月より長い、4ヶ月より長い、または5ヶ月より長い半減期を有する、RSV抗原と免疫特異的に結合する1種以上の抗体またはそのフラグメントを含んでなる液体製剤を提供する。抗体の半減期を延長することによって、抗体の投与量を少なくすることができ、かつ/または投与回数をを減らすことが可能である。
本発明は、限定されるものではないが、ペプチド、ポリペプチド、タンパク質、融合タンパク質、核酸分子、小分子、ミメティック物質、合成薬物、無機分子および有機分子をはじめとする1以上の部分とコンジュゲートされた、RSV抗原と免疫特異的に結合する抗体またはそのフラグメントの液体製剤の使用を包含する。
r. 45: 3580-4頁 (2001)、Mohammadら, Anticancer Drugs 12: 735-40頁 (2001)、Wallら, Biochem. Biophys. Res. Commun. 266: 76-80頁 (1999)、Mohammadら, Int. J. Oncol. 15: 367-72頁 (1999)(それらの全ては参照により本明細書に組み入れられる)を参照); 細胞分裂抑制薬(例えば、ビンクリスチンおよびビンブラスチン); ホルモン(例えば、糖質コルチコイド、プロゲスタチン、アンドロゲン、およびエストロゲン); DNA修復酵素阻害剤(例えば、エトポシドまたはトポテカン); キナーゼ阻害剤(例えば、化合物 ST1571、メシル酸イマチニブ(Kantarjianら, Clin Cancer Res. 8 (7): 2167 76頁 (2002))、および、米国特許第6,245,759号、同第6,399,633号、同第6,383,790号、同第6,335,156号、同第6,271,242号、同第6,242,196号、同第6,218,410号、同第6,218,372号、同第6,057,300号、同第6,034,053号、同第5,985,877号、同第5,958,769号、同第5,925,376号、同第5,922,844号、同第5,911,995号、同第5,872,223号、同第5,863,904号、同第5,840,745号、同第5,728,868号、同第5,648,239号、および同第5,587,459号で開示されている化合物); ファルネシルトランスフェラーゼ阻害剤(例えば、R115777、BMS 214662、および、例えば、米国特許第6,458,935号、同第6,451,812号、同第6,440,974号、同第6,436,960号、同第6,432,959号、同第6,420,387号、同第6,414,145号、同第6,410,541号、同第6,410,539号、同第6,403,581号、同第6,399,615号、同第6,387,905号、同第6,372,747号、同第6,369,034号、同第6,362,188号、同第6,342,765号、同第6,342,487号、同第6,300,501号、同第6,268,363号、同第6,265,422号、同第6,248,756号、同第6,239,140号、同第6,232,338号、同第6,228,865号、同第6,228,856号、同第6,225,322号、同第6,218,406号、同第6,211,193号、同第6,187,786号、同第6,169,096号、同第6,159,984号、同第6,143,766号、同第6,133,303号、同第6,127,366号、同第6,124,465号、同第6,124,295号、同第6,103,723号、同第6,093,737号、同第6,090,948号、同第6,080,870号、同第6,077,853号、同第6,071,935号、同第6,066,738号、同第6,063,930号、同第6,054,466号、同第6,051,582号、同第6,051,574号、および同第6,040,305号で開示されているもの); トポイソメラーゼ阻害剤(例えば、カンプトセシン、イリノテカン、SN 38、トポテカン、9 アミノカンプトセシン、GG 211(GI 147211)、DX 8951f; IST 622、ルビテカン、ピラゾロアクリジン、XR 5000、サントピン(saintopin)、UCE6、UCE1022、TAN 1518A、TAN 1518B、KT6006、KT6528、ED 110、NB 506、ED 110、NB 506、レベッカマイシン、およびブルガレイン(bulgarein)); DNA副溝結合剤(例えば、Hoescht dye 33342およびHoechst dye 33258); ニチジン(nitidine); ファガロニン(fagaronine); エピベルベリン(epiberberine); コラリン(coralyne); βラパチョーネ; BC 4 1; ならびにその医薬上許容される塩、溶媒和物、包接体、およびプロドラッグ(例えば、Rothenberg, M. L., Annals of Oncology 8: 837 855頁 (1997); およびMoreauら, J. Med. Chem. 41: 1631 1640頁 (1998)を参照)が挙げられる。また、治療用成分が、アンチセンスオリゴヌクレオチド(例えば、米国特許第6,277,832号、同第5,998,596号、同第5,885,834号、同第5,734,033号、および同第5,618,709号で開示されているもの); 免疫調節薬(例えば、抗体およびサイトカイン); 抗体(例えば、リツキシマブ(Rituxan(登録商標))、カリーチアマイシン(Mylotarg(登録商標))、イブリツモマブ・チウキセタン(Zevalin(登録商標))、およびトシツモマブ(Bexxar(登録商標)); ならびにアデノシンデアミナーゼ阻害剤(例えば、リン酸フルダラビンおよび2 クロロデオキシアデノシン)であってもよい。
本発明は、RSV抗原と免疫特異的に結合する抗体、特に、表2に記載されている抗体、またはその誘導体、類似体、もしくはフラグメントの液体製剤の調製方法を提供する。図1は精製された抗RSV抗体の調製に関する概要を示す説明図である。本発明の液体製剤の調製方法は、精製された抗体またはフラグメントを含んでいる画分を、好適な分子量(MW)カットオフ(例えば、完全抗体分子およびF(ab')2フラグメントの場合では30kDカットオフ、およびFabフラグメントなどの抗体フラグメントの場合では10kDカットオフ)の半透膜を使用して、最終的な抗体またはフラグメント濃度約15mg/ml、約20mg/ml、約30mg/ml、約40mg/ml、約50mg/ml、約60mg/ml、約70mg/ml、約80mg/ml、約90mg/ml、約100mg/ml、約110mg/ml、約125mg/ml、約150mg/ml、約200mg/ml、約250mg/ml、または約300mg/mlまで濃縮すること、および、濃縮された抗体画分を同じ膜を使用して調剤バッファーにダイアフィルトレーションすることよりなる。RSV抗原と免疫特異的に結合する抗体またはそのフラグメントを含むコンディショニング培地に対してCUNOフィルトレーションを行い、フィルトレーションした抗体に対してHS50陽イオン交換クロマトグラフィーを行う。次いで、HS50陽イオン交換クロマトグラフィーからの画分に対してγプロテイン A アフィニティークロマトグラフィー、続いて、低pH処理を行う。低pH処理後、抗体画分に対してスーパー Q 650 陰イオン交換クロマトグラフィー、次いで、ナノフィルトレーションを行う。次いで、ナノフィルトレーション後に得られた抗体の画分に対してダイアフィルトレーションを行い、同じ膜を使用して調剤バッファーに抗体画分を濃縮する。
RSV抗原と免疫特異的に結合する抗体は、抗体の合成に関する当技術分野で公知のいずれかの方法により、特に、化学合成により、または、好ましくは、組換え発現技術により作製することができる。
本発明は、抗原と免疫特異的に結合する抗体またはそのフラグメントをコードするヌクレオチド配列を含んでなるポリヌクレオチドを提供する。本発明はまた、例えば、上記のような、高いストリンジェンシー、中度のもしくは低いストリンジェンシーのハイブリダイゼーション条件下で、本発明の抗体をコードするポリヌクレオチドとハイブリダイズするポリヌクレオチドも包含する。
本発明の抗体、その誘導体、類似体またはフラグメント(例えば、本発明の抗体の重鎖もしくは軽鎖、あるいはその一部、または本発明の単鎖抗体)の組換え発現は、抗体をコードするポリヌクレオチドを含有する発現ベクターの構築を必要とする。本発明の、抗体分子または抗体の重鎖もしくは軽鎖、あるいはそれらの一部(好ましくは、必ずしも必要ではないが、重鎖または軽鎖可変ドメインを含有する)をコードするポリヌクレオチドが一度得られたら、抗体分子を作製するためのベクターは、当技術分野で周知の技術を利用して組換えDNAテクノロジーにより作製し得る。例えば、その全開示内容が参照により本明細書に組み入れられる米国特許第6,331,415号を参照のこと。よって、抗体をコードするヌクレオチド配列を含有するポリヌクレオチドを発現させることによりタンパク質を作製する方法を明細書に記載する。当業者に周知の方法を利用して、抗体コード配列および好適な転写および翻訳制御シグナルを含有する発現ベクターを構築することができる。これらの方法としては、例えば、in vitro組換えDNA技術、合成技術、およびin vivo遺伝子組換えが挙げられる。従って、本発明は、本発明の抗体分子、抗体の重鎖もしくは軽鎖、抗体の重鎖もしくは軽鎖可変ドメインまたはそれらの一部、あるいは重鎖もしくは軽鎖のCDRをコードする、プロモーターと機能しうる形で連結されたヌクレオチド配列を含んでなる複製ベクターを提供する。このようなベクターは、抗体分子の定常領域をコードするヌクレオチド配列(例えば、国際公開番号WO 86/05807およびWO 89/01036; ならびに米国特許第5,122,464号を参照)を含んでいてもよく、また、抗体の可変ドメインをこのようなベクターにクローニングして、重鎖全体、軽鎖全体、または重鎖全体と軽鎖全体の両方を発現させてもよい。
に結合する抗体をコードするヌクレオチド配列の発現を、構成的プロモーター、誘導プロモーターまたは組織特異的プロモーターにより調節する。
本発明の液体製剤の安定性を、タンパク質の物理的および化学的構造(例えば、抗体またはそのフラグメント)に基づいて評価する、ならびにそれらの生物活性に基づいて評価するためには、利用可能な種々の方法がある。例えば、タンパク質の変性の検討には、電荷移動吸収、熱分析、蛍光分光法、円偏光二色性、NMR、およびHPSECなどの方法が利用できる。例えば、Wangら, 1988, J. of Parenteral Science & Technology 42 (Suppl): S4-S26頁を参照のこと。
本発明はまた、抗体に基づく療法であって、RSV感染、その1以上の症状、またはRSV感染に結び付くか、RSV感染により増強されるか、もしくは、RSV感染を増強する呼吸器症状を予防、治療、管理または改善するために、本発明の液体抗体製剤を被験体、好ましくは、ヒトに投与することを含む療法を対象とする。本発明の液体製剤は、ヒスチジンを含有する溶液中約15mg/ml〜約300mg/mlの濃度にて抗体またはそのフラグメントを含んでなり、その抗体またはそのフラグメントがRSV抗原と免疫特異的に結合する。本発明の液体製剤は、RSV抗原と免疫特異的に結合する単一種の抗体またはそのフラグメント(ただし、該抗体または抗体フラグメントはSYNAGIS(登録商標)またはそのフラグメントではない)を含んでなってよい。本発明の液体製剤はまた、RSV抗原と免疫特異的に結合する2種以上の抗体またはそのフラグメントを含んでなってよい。特定の実施形態では、このような液体製剤に含められる抗体または抗体フラグメントのうち1種がSYNAGIS(登録商標)またはそのフラグメントである。別の実施形態では、このような液体製剤に含められる抗体または抗体フラグメントのうち1種がSYNAGIS(登録商標)またはそのフラグメントではない。
本発明は、RSV感染、その1以上の症状、またはRSV感染に結び付くか、RSV感染により増強されるか、もしくは、RSV感染を増強する呼吸器症状を予防、管理、治療または改善する方法であって、それを必要とする被験体に1種以上の本発明の抗体液体製剤を単独で、または、本発明の抗体液体製剤以外の1種以上の療法(例えば、1種以上の予防薬または治療薬)と組み合わせて投与することを含んでなる方法を提供する。本発明は、RSV感染、その1以上の症状、またはRSV感染に結び付くか、RSV感染により増強されるか、もしくは、RSV感染を増強する呼吸器症状(例えば、気道過敏性、喘息など)を予防、管理、治療または改善する方法であって、それを必要とする被験体に1種以上の本発明の液体製剤を単独で、または、本発明の抗体液体製剤以外の1種以上の療法(例えば、1種以上の予防薬または治療薬)と組み合わせて投与することを含んでなる方法を提供する。本発明はまた、RSV抗原と免疫特異的に結合する抗体またはそのフラグメントと本発明の液体抗体製剤以外の1種以上の予防薬または治療薬の液体製剤を含んでなる組成物、ならびに該組成物を使用して、RSV感染、その1以上の症状、またはRSV感染に結び付くか、RSV感染により増強されるか、もしくは、RSV感染を増強する呼吸器症状を予防、管理、治療または改善する方法も提供する。治療薬または予防薬としては、限定されるものではないが、小分子、合成薬物、ペプチド、ポリペプチド、タンパク質、核酸(例えば、DNAおよびRNAヌクレオチド、限定されるものではないが、アンチセンスヌクレオチド配列、三重らせん、RNA干渉(RNAi)、および生物活性のあるタンパク質、ポリペプチド、またはペプチドをコードするヌクレオチド配列を含む)抗体、合成または天然無機分子、ミメティック物質、ならびに合成または天然有機分子が挙げられる。
当業者に周知のいずれの免疫調節薬も、本発明の方法および組成物に使用し得る。免疫調節薬は、被験体の免疫応答の1以上またはあらゆる態様に影響を及ぼすことができる。免疫応答の態様としては、限定されるものではないが、炎症性応答、補体カスケード、白血球およびリンパ球の分化、増殖、および/またはエフェクター機能、単球および/または好塩基球数、ならびに免疫系の細胞間の細胞コミュニケーションが挙げられる。本発明の特定の実施形態では、免疫調節薬が免疫応答の1つの態様をモジュレートする。他の実施形態では、免疫調節薬が免疫応答の2以上の態様をモジュレートする。本発明の好ましい実施形態では、免疫調節薬の被験体への投与により被験体の免疫応答能力の1以上の態様が抑制されるかまたは低下する。本発明の別の実施形態では、免疫調節薬が被験体の免疫応答の1以上の態様を高める。本発明の特定の実施形態では、免疫調節薬が抗炎症薬ではない。他の実施形態では、免疫調節薬が化学療法薬以外の薬剤である。
特定の実施形態では、本発明の液体製剤がRSV感染、またはRSV感染に結び付くか、RSV感染により増強されるか、もしくは、RSV感染を増強する呼吸器症状を予防または治療するために、インターロイキン-9(IL-9)アンタゴニストと組み合わせて使用される。本明細書において「IL-9アンタゴニスト」とは、IL-9タンパク質、ポリペプチドまたはペプチドの機能、活性および/または発現をブロックするか、抑制するか、低減するか、または中和する薬剤を指す。IL-9アンタゴニストは、IL-9の発現および/または活性(例えば、ムチンの分泌の減少、IL-9発現細胞のムチン分泌細胞への分化、炎症性因子の分泌、細胞(例えば、免疫細胞および平滑筋細胞)の増殖、移動、およびその体積の増加、細胞外基質分子もしくは基質メタロプロテイナーゼの分泌ならびに/またはIL-9とIL-9受容体("IL-9R")との結合)と関連するか、またはそれによってもたらされる病的細胞表現型または体液表現型を抑制し得る。IL-9アンタゴニストは、2003年4月11日に出願された米国出願番号60/462,307、および2003年4月11日に出願された同60/462,259(それらのいずれもが参照により本明細書に組み入れられる)で開示されている。
炎症性疾患の療法で有用な当業者に周知の薬剤を含むいずれの抗炎症薬も本発明の組成物および方法において使用できる。抗炎症薬の限定されない例としては、非ステロイド系抗炎症薬(NSAID)、ステロイド系抗炎症薬、抗コリン作用薬(例えば、硫酸アトロピン、硝酸メチルアトロピン、および臭化イプラトロピウム(ATROVENT(商標)))、β2-アゴニスト(例えば、アブテロール(abuterol)(VENTOLIN(商標)およびPROVENTIL(商標))、ビトルテロール(TORNALATE(商標))、レボサルブタモール(XOPONEX(商標))、メタプロテレノール(ALUPENT(商標))、ピルブテロール(MAXAIR(商標))、テルブトライン(terbutlaine)(BRETHAIRE(商標)およびBRETHINE(商標))、アルブテロール(PROVENTIL(商標)、REPETABS(商標)、およびVOLMAX(商標))、ホルモテロール(FORADILAEROLIZER(商標))、およびサルメテロール(SEREVENT(商標)およびSEREVENT DISKUS(商標)))ならびにメチルキサンチン(例えば、テオフィリン(UNIPHYL(商標)、THEO-DUR(商標)、SLO-BID(商標)、ANDTEHO-42(商標)))が挙げられる。NSAIDの例としては、限定されるものではないが、アスピリン、イブプロフェン、セレコキシブ(CELEBREX(商標))、ジクロフェナク(VOLTAREN(商標))、エトドラク(LODINE(商標))、フェノプロフェン(NALFON(商標))、インドメタシン(INDOCIN(商標))、ケトロラック(ketoralac)(TORADOL(商標))、オキサプロジン(DAYPRO(商標))、ナブメントン(nabumentone)(RELAFEN(商標))、スリンダク(CLINORIL(商標))、トルメンチン(tolmentin)(TOLECTIN(商標))、ロフェコキシブ(VIOXX(商標))、ナプロキセン(ALEVE(商標)、NAPROSYN(商標))、ケトプロフェン(ACTRON(商標))およびナブメトン(RELAFEN(商標))が挙げられる。このようなNSAIDは、シクロオキシゲナーゼ酵素(例えば、COX-1および/またはCOX-2)を阻害することによって機能する。ステロイド系抗炎症薬の例としては、限定されるものではないが、糖質コルチコイド、デキサメタゾン(DECADRON(商標))、コルチコステロイド(例えば、メチルプレドニゾロン(MEDROL(商標)))、コルチゾン、ヒドロコルチゾン、プレドニゾン(PREDNISONE(商標)およびDELTASONE(商標))、プレドニゾロン(PRELONE(商標)およびPEDIAPRED(商標))、トリアムシノロン、アズルフィジン、およびエイコサノイドの阻害剤(例えば、プロスタグランジン、トロンボキサン、およびロイコトリエン(ロイコトリエンの限定されない例およびこのような薬剤の一般投与量については、以下の表2を参照)が挙げられる。
RSV感染、またはRSV感染に結び付くか、RSV感染により増強されるか、もしくは、RSV感染を増強する呼吸器症状を治療、予防、管理または改善するための当業者に周知のいずれの抗ウイルス薬も本発明の組成物および方法において使用できる。抗ウイルス薬の限定されない例としては、ウイルスのその受容体への結合、ウイルスの細胞へのインターナリゼーション、ウイルスの複製、または細胞からのウイルスの放出を抑制するおよび/または減少させるタンパク質、ポリペプチド、ペプチド、融合タンパク質、抗体、核酸分子、有機分子、無機分子、および小分子が挙げられる。特に、抗ウイルス薬としては、限定されるものではないが、ヌクレオシド類似体(例えば、ジドブジン、アシクロビル、ガンシクロビル、ビダラビン、イドクスウリジン、トリフルウリジン、およびリバビリン)、フォスカーネット、アマンタジン、リマンタジン、サキナビル、インジナビル、リトナビル、α-インターフェロンおよび他のインターフェロン、ならびにAZTが挙げられる。
RSV感染に結び付くか、RSV感染により増強されるか、または、RSV感染を増強する呼吸器症状(例えば、細菌性呼吸器系感染症)を予防、治療、管理または改善するための当業者に周知の抗菌薬および療法を本発明の組成物および方法において使用できる。抗菌薬の限定されない例としては、細菌感染を抑制および/もしくは減少させる、細菌の複製を抑制および/もしくは減少させる、または細菌の他の細胞または被験体への拡大を抑制および/もしくは減少させるタンパク質、ポリペプチド、ペプチド、融合タンパク質、抗体、核酸分子、有機分子、無機分子、および小分子が挙げられる。抗菌薬の特定の例としては、限定されるものではないが、抗生物質、例えば、ペニシリン、セファロスポリン、イミペネム、アクストレオナム(axtreonam)、バンコマイシン、サイクロセリン、バシトラシン、クロラムフェニコール、エリスロマイシン、クリンダマイシン、テトラサイクリン、ストレプトマイシン、トブラマイシン、ゲンタマイシン、アミカシン、カナマイシン、ネオマイシン、スペクチノマイシン、トリメトプリム、ノルフロキサシン、リファンピン、ポリミキシン、アムホテリシン B、ナイスタチン、ケトコナゾール(ketocanazole)、イソニアジド、メトロニダゾール、およびペンタミジン、が挙げられる。
びストレプトマイシンであることが好ましい。肺または呼吸器系細菌感染が好気性グラム陰性桿菌(GNB)が原因の肺炎である場合には、抗菌薬がペニシリン、第一世代、第二世代、または第三世代セファロスポリン系(例えば、セファクロール、セファドロキシル、セファレキシン、またはセファゾリン)、エリソマイシン、クリンダマイシン、アミノグリコシド系(例えば、ゲンタマイシン、トブラマイシン、またはアミカシン)、またはモノバクタム系(例えば、アズトレオナム)であることが好ましい。呼吸器系感染が再発性吸引性肺炎である場合には、抗菌薬がペニシリン、アミノグリコシド系、または第二世代、もしくは第三世代セファロスポリン系であることが好ましい。
RSV感染に結び付くか、RSV感染により増強されるか、または、RSV感染を増強する呼吸器症状(例えば、真菌性呼吸器系感染)を予防、管理、治療および/または改善するための当業者に周知の抗真菌薬および療法を本発明の組成物および方法において使用できる。抗真菌薬の限定されない例としては、真菌感染を抑制および/もしくは減少させる、真菌の複製を抑制および/もしくは減少させる、または真菌の他の被験体への拡大を抑制および/もしくは減少させるタンパク質、ポリペプチド、ペプチド、融合タンパク質、抗体、核酸分子、有機分子、無機分子、および小分子が挙げられる。抗真菌薬の特定の例としては、限定されるものではないが、アゾール系薬物(例えば、ミコナゾール、ケトコナゾール(NIZORAL(登録商標))、酢酸カスポファンギン(CANCIDAS(登録商標))、イミダゾール、トリアゾール類(例えば、フルコナゾール(DIFLUCAN(登録商標)))、およびイトラコナゾール(SPORANOX(登録商標)))、ポリエン(例えば、ナイスタチン、アムホテリシン B(FUNGIZONE(登録商標))、アムホテリシン B 脂質複合体("ABLC")(ABELCET(登録商標))、アムホテリシン B コロイド分散("ABCD")(AMPHOTEC(登録商標))、リポソームアムホテリシン B(AMBISONE(登録商標)))、ヨウ化カリウム(KI)、ピリミジン(例えば、フルシトシン(ANCOBON(登録商標)))、ならびにボリコナゾール(VFEND(登録商標))が挙げられる。
本発明は、有効な量の本発明の液体製剤を被験体に投与することにより、RSV感染、その1以上の症状、またはRSV感染に結び付くか、RSV感染により増強されるか、もしくは、RSV感染を増強する呼吸器症状を治療、予防および改善する方法を提供する。被験体は、好ましくは、非霊長類(例えば、ウシ、ブタ、ウマ、ネコ、イヌ、ラットなど)および霊長類(例えば、カニクイザルなどのサルおよびヒト)などの哺乳類である。好ましい実施形態では、被験体がヒトである。もう1つの好ましい実施形態では、被験体がヒト乳児または早産で産まれたヒト乳児である。
感染、その1以上の症状、またはRSV感染に結び付くか、RSV感染により増強されるか、もしくは、RSV感染を増強する呼吸器症状を治療、予防、管理または改善するためにヒトに投与することができる投与量である。さらに、所望により、最適な投与量の範囲を確認するためにin vitroアッセイを利用してもよい。
5.7.1 本発明の抗体の免疫特異性
本発明の抗体またはそのフラグメントは、当業者に周知の種々の方法により特徴付けられる。特に、本発明の抗体またはそのフラグメントを、呼吸器合胞体ウイルスのエピトープと免疫特異的に結合する能力についてアッセイする。このようなアッセイは溶液中(例えば、Houghten, 1992, Bio/Techniques 13: 412-421頁)、ビーズ上(Lam, 1991, Nature 354: 82-84頁)、チップ上(Fodor, 1993, Nature 364: 555-556頁)、細菌上(米国特許第5,223,409号)、胞子上(米国特許第5,571,698号; 同第5,403,484号; および同第5,223,409号)、プラスミド上(Cullら, 1992, Proc. Natl. Acad. Sci. USA 89: 1865-1869頁)、またはファージ上(ScottおよびSmith, 1990, Science 249: 386-390頁; Cwirlaら, 1990, Proc. Natl. Acad. Sci. USA 87: 6378-6382頁; ならびにFelici, 1991, J. Mol. Biol. 222: 301-310頁)(これらの参考文献の各々はその全開示内容が参照により本明細書に組み入れられる)で実施し得る。本発明の液体製剤中の本発明の抗体またはそのフラグメントをその特異性および親和性についてアッセイすることができる。
抗体またはそのフラグメント、本発明の液体製剤、または本発明の併用療法をin vitroおよび/またはin vivoにて種々のアッセイまたは好適な動物モデル系においてその活性について試験することができる。
本発明の予防および/または治療プロトコールの毒性および/または有効性は、細胞培養物または試験動物において、標準的な薬学的手法、例えば、LD50(集団の50%が死に至る用量)およびED50(集団の50%に治療上有効な用量)を決定する方法により決定することができる。毒性と治療効果との間の用量比が治療指数であり、比LD50/ED50として表すことができる。大きい治療指数を示す療法が好ましい。毒性副作用を示す療法を使用することはできるが、感染していない細胞に対する潜在的損傷を最小限にし、それにより副作用を低減するために、かかる薬剤を罹患組織部位にターゲッティングする送達系を設計するように注意を払わなければならない。
本発明は、RSV感染、その1以上の症状、またはRSV感染に結び付くか、RSV感染により増強されるか、もしくは、RSV感染を増強する呼吸器症状を予防、治療、管理または改善するための本発明の液体製剤を充填した1以上の容器を含んでなる医薬パックまたはキットを提供する。本発明はまた、RSV感染を検出、診断またはモニターリングするための本発明の液体製剤を充填した1以上の容器を含んでなる医薬パックまたはキットも提供する。特定の実施形態では、本発明の液体製剤は、限定されるものではないが、異種タンパク質、異種ポリペプチド、異種ペプチド、大分子、小分子、マーカー配列、診断薬または検出可能な薬剤、治療用成分、薬物成分、放射性金属イオン、二次抗体、および固体支持体といった別の部分と組換えにより融合されたか、またはそれと化学的にコンジュゲートされたRSV抗原と免疫特異的に結合する抗体またはそのフラグメントを含んでなる。
RSV抗原と免疫特異的に結合する、標識された抗体またはそのフラグメント、誘導体および類似体を含んでなる本発明の液体製剤を、RSV感染を検出、診断、またはモニターリングする診断用途に使用することができる。このような診断技術は当技術分野で公知であり、これらの技術としては、限定されるものではないが、国際公開番号WO 01/58483、米国特許第6,248,326号、Pecheurら, The FASEB J. 16 (10): 1266-8頁 (2002)、Almedら, The Journal of Histochemistry & Cytochemistry 50: 1371-1379頁 (2002)(それらの全ては参照により本明細書に組み入れられる)に開示されているものが挙げられる。好ましい実施形態では、RSV抗原と免疫特異的に結合する抗体を、RSV感染を検出、診断、またはモニターリングする診断用途に使用する。感染の検出または診断は、当業者に周知の技術を用いた、限定されるものではないが、被験体から採取したサンプル(ここで、このようなサンプルは、限定されるものではないが、被験体の気道からの分泌物(例えば、痰および唾液)および血液であってよい)をアッセイすることをはじめとする、in vitroアッセイにおいて有効な量(すなわち、RSV抗原の発現を検出し得るために有効な量)の本発明の液体製剤を利用することにより実施することができる。
安定性試験
水性担体中に、25mMのヒスチジン、1.6mMのグリシン、および抗RSV抗体を含んでなる本発明の抗体製剤を以下のプロトコールに従って調製する:
1kgバッファー溶液について: 800g水に、3.875gヒスチジン(遊離塩基)および0.12gグリシンを溶かす。そのpHを6N HClを用いて6.0±0.2に調整する。水を添加して全質量1.0kg(qs)とする。
当業者ならば、明細書において記載する本発明の特定の実施形態の数多くの均等物が明らかであるだろうし、または単なる日常的に利用している試験によって確かめることができるであろう。このような均等物は、特許請求の範囲内に含まれることが意図される。
Claims (57)
- (a)少なくとも15mg/mlの、RSV抗原と免疫特異的に結合する抗体またはそのフラグメント、および(b)水性担体中のヒスチジンを含んでなる液体抗体製剤であって、該製剤が界面活性剤、無機塩または他の賦形剤を実質的に含まず、かつ、該抗体または抗体フラグメントがSYNAGIS(登録商標)またはそのフラグメントではない、前記液体抗体製剤。
- (a)少なくとも15mg/mlの、RSV抗原と免疫特異的に結合する1種以上の抗体またはそのフラグメント、および
(b)水性担体中のヒスチジン
を含んでなる液体抗体製剤であって、該製剤が界面活性剤、無機塩または他の賦形剤を実質的に含まず、かつ、該抗体または抗体フラグメントの少なくとも1種がSYNAGIS(登録商標)またはそのフラグメントである、前記液体抗体製剤。 - 水性担体が蒸留水である、請求項1または2に記載の製剤。
- 無菌である、請求項1に記載の製剤。
- 均質である、請求項1に記載の製剤。
- 約5.5〜6.5の範囲のpHを有する、請求項1または2に記載の製剤。
- 抗体または抗体フラグメントの濃度が少なくとも100mg/mlである、請求項1に記載の製剤。
- 抗体または抗体フラグメントの濃度が少なくとも110mg/mlである、請求項1に記載の製剤。
- 抗体または抗体フラグメントの濃度が少なくとも150mg/mlである、請求項8に記載の製剤。
- 抗体または抗体フラグメントの濃度が少なくとも160mg/mlである、請求項9に記載の製剤。
- ヒスチジンの濃度が約10〜約30mMである、請求項1または2に記載の製剤。
- グリシンをさらに含む、請求項1または2に記載の製剤。
- グリシンの濃度が3.0mM未満である、請求項12に記載の製剤。
- HPSECにより判定した場合、RSV抗原と免疫特異的に結合する抗体または抗体フラグメントが40℃にて少なくとも100日間安定である、請求項1に記載の製剤。
- HPSECにより判定した場合、RSV抗原と免疫特異的に結合する抗体または抗体フラグメントがおよそ周囲温度にて少なくとも1年間安定である、請求項1に記載の製剤。
- HPSECにより判定した場合、RSV抗原と免疫特異的に結合する抗体または抗体フラグメントが4℃にて少なくとも3年間安定である、請求項1に記載の製剤。
- HPSECにより判定した場合、RSV抗原と免疫特異的に結合する抗体または抗体フラグメントが4℃にて3〜5年間安定である、請求項1に記載の製剤。
- HPSECにより判定した場合、RSV抗原と免疫特異的に結合する抗体または抗体フラグメントが4℃にて少なくとも5年間安定である、請求項1に記載の製剤。
- HPSECにより測定した場合、2%未満の抗体または抗体フラグメントが凝集体を形成する、請求項1に記載の製剤。
- HPSECにより測定した場合、1%未満の抗体または抗体フラグメントが凝集体を形成する、請求項19に記載の製剤。
- HPSECにより測定した場合、0.5%未満の抗体または抗体フラグメントが凝集体を形成する、請求項20に記載の製剤。
- 賦形剤をさらに含む、請求項1または2に記載の製剤。
- 賦形剤が糖類である、請求項22に記載の製剤。
- 糖類がスクロースである、請求項23に記載の製剤。
- スクロースの濃度が約1%〜約20%である、請求項24に記載の製剤。
- 賦形剤がマンニトール以外のポリオールである、請求項22に記載の製剤。
- ポリオールがポリソルベートである、請求項26に記載の製剤。
- Tweenの濃度が約0.001%〜約1%である、請求項27に記載の製剤。
- 抗体がAFFF、p12f2、p12f4、p11d4、Ale109、A12a6、A13c4、A17d4、A4B4、A8C7、1X-493L1FR、H3-3F4、M3H9、Y1OH6、DG、AFFF(1)、6H8、L1-7E5、L215B10、A13A11、A1H5、A4B4(1)、A4B4L1FR-S28R、またはA4B4-F52Sである、請求項4に記載の製剤。
- 抗体または抗体フラグメントが配列番号9、17、24、28、33、36、40、44、48、51、55、67、70、または78のアミノ酸配列を有する重鎖可変(VH)ドメインを含む、請求項4に記載の製剤。
- 抗体または抗体フラグメントが配列番号11、13、21、26、30、34、38、42、46、49、52、54、56、58、60、62、64、65、68、71、74、または76のアミノ酸配列を有する軽鎖可変(VL)ドメインを含む、請求項4に記載の製剤。
- 抗体がA4B4、A4B4(1)、A4B4L1FR-S28R、またはA4B4-F52Sである、請求項4に記載の製剤。
- 抗体または抗体フラグメントが配列番号48の重鎖可変(VH)ドメインを含む、請求項4に記載の製剤。
- 抗体または抗体フラグメントが配列番号11、49、74または76のアミノ酸配列を有する軽鎖可変(VL)ドメインを含む、請求項4に記載の製剤。
- 抗体または抗体フラグメントが抗体 A4B4、A4B4(1)、A4B4L1FR-S28R、またはA4B4-F52SのVH CDRを含む、請求項4に記載の製剤。
- 抗体または抗体フラグメントが抗体 A4B4、A4B4(1)、A4B4L1FR-S28R、またはA4B4-F52SのVL CDRを含む、請求項4に記載の製剤。
- 抗体または抗体フラグメントが配列番号10のアミノ酸配列を有するVHCDR1、配列番号19のアミノ酸配列を有するVHCDR2、および配列番号20のアミノ酸配列を有するVHCDR3を含む、請求項4に記載の製剤。
- 抗体または抗体フラグメントが配列番号39のアミノ酸配列を有するVLCDR1、配列番号5のアミノ酸配列を有するVLCDR2、および配列番号6のアミノ酸配列を有するVLCDR3を含む、請求項4に記載の製剤。
- 抗体または抗体フラグメントが配列番号39のアミノ酸配列を有するVLCDR1、配列番号77のアミノ酸配列を有するVLCDR2、および配列番号6のアミノ酸配列を有するVLCDR3を含む、請求項4に記載の製剤。
- 該工程の各ステップで、該抗体またはそのフラグメントが水相にあるプロセスにより製造された、請求項1に記載の製剤。
- 乾燥ステップのない工程により製造された、請求項1に記載の製剤。
- 凍結乾燥ステップのない工程により製造された、請求項1に記載の製剤。
- 好適な容器に請求項1、4、または29に記載の抗体製剤を含む、ヒトへの非経口投与に好適な、医薬単位投与剤型。
- 該抗体またはそのフラグメントが1ml〜20ml量中、約15mg/ml〜約300mg/mlの濃度を有する、請求項43に記載の医薬単位投与剤型。
- 該抗体またはそのフラグメントが1.2ml量中、100mg/mlの濃度を有する、請求項44に記載の医薬単位投与剤型。
- 抗体製剤が皮下投与に好適である、請求項43に記載の医薬単位投与剤型。
- 抗体製剤が静脈内投与に好適である、請求項43に記載の医薬単位投与剤型。
- 抗体製剤が筋肉内投与に好適である、請求項43に記載の医薬単位投与剤型。
- 好適な容器に請求項1、4、または29に記載の抗体製剤を含む、ヒトへのエアゾール投与に好適な、医薬単位投与剤型。
- 該抗体またはそのフラグメントが1.1ml〜1.3ml量中、約15mg/ml〜約300mg/mlの濃度を有する、請求項49に記載の医薬単位投与剤型。
- 請求項1、3、4、または29に記載の製剤を含む、密封容器。
- 被験体においてRSV感染に関わる1以上の症状を予防、治療または改善する方法であって、予防上または治療上有効な量の請求項1、4、29、32、35または36に記載の製剤を投与することを含む方法。
- 製剤が非経口的に投与される、請求項52に記載の方法。
- 製剤が筋肉内に投与される、請求項52に記載の方法。
- 製剤が静脈内に投与される、請求項52に記載の方法。
- 製剤が皮下に投与される、請求項52に記載の方法。
- 製剤が鼻腔内に投与される、請求項52に記載の方法。
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AU2003276402B2 (en) | 2010-05-20 |
JP2010159273A (ja) | 2010-07-22 |
EP1576105A2 (en) | 2005-09-21 |
WO2003106644A2 (en) | 2003-12-24 |
AU2010212375A1 (en) | 2010-09-09 |
AU2010212375B2 (en) | 2011-06-23 |
CA2489534A1 (en) | 2003-12-24 |
AU2003276402A1 (en) | 2003-12-31 |
US7425618B2 (en) | 2008-09-16 |
WO2003106644A3 (en) | 2006-06-29 |
US20040018200A1 (en) | 2004-01-29 |
EP1576105A4 (en) | 2007-05-23 |
US20090175883A1 (en) | 2009-07-09 |
US20120045456A1 (en) | 2012-02-23 |
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